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October 2015 Newsletter
GRAND ROUNDS
A 9 months old boy presented was started on antituberculous therapy (ATT) for non-resolving pneumonia. He had delayed development also. On examination, he had generalized non-significant lymphadenopathy, weight of 5.4 kg, hepatomegaly and crepts bilaterally. HIV ELISA was positive and HIV viral load was 11,60,000 copies/ml by COBAS Ampiclor method. He was started on antiretroviral therapy (ART) consisting of stavudine (d4T), lamivudine (3TC) and nevirapine (NVP). He developed BCG adenitis after 15 days after starting ART which subsided gradually. At 15 months of age, his weight had increased to 8.5 kg and he had achieved milestones in form of babbling and standing with support, however he had bilateral lower limb spasticity. An MRI brain done at 20 months of age that showed patchy hypodensity in both parietal white matter on T2 weighted images. He was advised physiotherapy. At 30 months, he is now able to speak few words and can walk with support.
What is the cause of his delayed development?
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A 32 years old HIV infected pregnant female (G2P2L1) presented at 36 weeks of pregnancy for deciding neonatal antiretroviral (ARV) prophylaxis. Her HIV viral load at 34 weeks of gestation was undetectable and she was on antiretroviral therapy (ART) consisting ....
HIV IN CHILDREN APPS